Project Title: Electronic Cigarettes in Youth with Asthma Project Summary/ Abstract: Asthma is the most common pediatric chronic illness in the United States, affecting over six million children and adolescents. While it is well established that traditional ?combustible? tobacco is an irritant and can initiate asthma exacerbations, little is known about the impact electronic cigarettes (ECs) may have on respiratory health of adolescents with asthma. ECs can look and feel like regular cigarettes but do not contain tobacco, require combustion, or produce smoke. ECs are currently being marketed to adult smokers as an alternative to cigarettes and are increasing in popularity. Alarmingly, use of ECs has tripled over the last two years among adolescents, and some studies estimate that as many as 1 in 5 adolescents aged 15-19 have tried ECs. Recent data indicate that youth with asthma are more likely than their healthy peers to use ECs. Despite these alarming rates of EC uptake among youth with asthma, little is understood about this phenomenon. The current study seeks to identify why youth with asthma may choose to use ECs, how they obtain ECs, and how they perceive the risk of ECs. First, we will characterize patterns of use, sociodemographic characteristics, access, and perceived harm of ECs in youth with asthma using the NIH/FDA Population Assessment of Tobacco and Health (PATH) Wave 1 Study Data. Second, we will use qualitative techniques to characterize reported knowledge of ECs, access, use, and perceived risk among youth with asthma who are current EC users (past 7 days) or have never used ECs in a series of six focus groups (n = 60). Qualitative data analysis will investigate themes associated with perceptions and use of ECs for youth with asthma. Lastly, we will evaluate the association between EC use and markers of respiratory health, including lung function (FEV1, FEV1/FEVC), and inflammation (exhaled nitric oxide; FeNO), in the same sample of 60 youth with asthma who are either current EC users or never-users to investigate potential acute effects of EC use on respiratory/inflammatory biomarkers. We anticipate a negative association between acute respiratory biomarkers (i.e., FEV1, FEV1/FVC, FeNO) and EC use. This innovative study will have both clinical and